J Korean Orthop Assoc.  2016 Aug;51(4):338-344. 10.4055/jkoa.2016.51.4.338.

Comparison of Intramedullary K-Wire Nailing versus Plate for Fixation in Metacarpal Midshaft Fracture

• Kim JY
• Lee YK
• Kong GM
• Kim DY
• Park JH
• Jung YR

• KMID: 2348641
• DOI: http://doi.org/10.4055/jkoa.2016.51.4.338

Abstract

PURPOSE
The purpose of this study was to compare the clinical and radiological results of patients with metacarpal midshaft fracture following surgery using either intramedullary K-wire nailing or internal fixation of plates.
MATERIALS AND METHODS
This study was conducted with 39 metacarpal midshaft fracture patients between October 2008 and September 2012. Of these 39 patients, 15 patients underwent intramedullary K-wire nailing and 24 patients underwent internal fixation of metal plates. We analyzed bone union time and final posterior angulation radiologically and the range of motion, grip power, and quick-disabilities of the arm, shoulder and hand (DASH) scores, visual analogue scale (VAS) score clinically.
RESULTS
Bone union was observed in all cases and bone union times were not significantly different between the two surgical methods. The final follow-up radiographs showed statistically significant differences in posterior angulation, which was 14°, on average, among the patients who underwent intramedullary K-wire nailing and 5°, on average, among the patients who underwent internal fixation of plates. No significant differences were found for the range of joint motion, power, and quick-DASH scores and VAS score were not significantly different between the two groups.
CONCLUSION
Intramedullary K-wire nailing showed significant differences in posterior angulations, but both intramedullary K-wire nailing and internal fixation of plates produced good clinical outcomes in the treatment of metacarpal midshaft fracture. Therefore both techniques are considered good treatment methods.

Keyword

metacarpal midshaft fracture; intramedullary K-wire nailing; internal fixation of plate

MeSH Terms

Arm
Follow-Up Studies
Hand
Hand Strength
Humans
Joints
Range of Motion, Articular
Shoulder

Figure

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  Figure 1 (A) Preoperative radiographs of the 4th metacarpal midshaft fracture. (B) Immediate postoperative radiographs.

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  Figure 2 Examples of metacarpal midshaft fracture following surgery using internal fixation of plate. (A) A 35-year-old man had a 4th metacarpal midshaft fracture due to slip down. (B) Internal fixation was performed.

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